Validity of self-reported weight, height, and BMI in mothers of the research Birth in Brazil

Araújo, Roberta Gabriela Pimenta da Silva; Gama, Silvana Granado Nogueira da; Barros, Denise Cavalcante de; Saunders, Cláudia; Mattos, Inês Echenique

doi:10.11606/S1518-8787.2017051006775

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Original Articles • Rev. Saúde Pública 51 • 2017 • https://doi.org/10.11606/S1518-8787.2017051006775 copy

Validity of self-reported weight, height, and BMI in mothers of the research Birth in Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE

To evaluate the accuracy of information on pre-gestational weight, height, pre-gestational body mass index, and weight at the last prenatal appointment, according to maternal characteristics and sociodemographic and prenatal variables.

METHODS

The study was developed using data from the face-to-face questionnaire and prenatal card (gold standard) of the study “Birth in Brazil, 2011–2012”. To evaluate the differences between the measured and self-reported anthropometric variables, we used the the Kruskal-Wallis test for the variables divided into quartiles. For the continuous variables, we used the Wilcoxon test, Bland-Altman plot, and average difference between the information measured and reported by the women. We estimated sensitivity and the intraclass correlation coefficient.

RESULTS

In the study, 17,093 women had the prenatal card. There was an underestimation of pre-gestational weight of 1.51 kg (SD = 3.44) and body mass index of 0.79 kg/m² (SD = 1.72) and overestimation of height of 0.75 cm (SD = 3.03) and weight at the last appointment of 0.22 kg (SD = 2.09). The intraclass correlation coefficients (ICC) obtained for the anthropometric variables were: height (ICC = 0.89), pre-gestational weight (ICC = 0.96), pre-gestational body mass index (ICC = 0.92), and weight at the last appointment (ICC = 0.98).

CONCLUSIONS

The results suggest that the mentioned anthropometric variables were valid for the study population, and they may be used in studies of populations with similar characteristics.

Pregnant Women; Body Weight; Body Height; Body Mass Index; Self-Assessment; Reproducibility of Results; Validation Studies

Variable		n	SD	Quartile				Total

				1st	2nd	3rd	4th
Height	Average measured	5,882	6.774	149.8	155.6	160.4	167.7	158.57
	Average reported	5,882	6.993	150.0	156.5	162.5	169.9	159.32
	Average height difference^c	5,882	3.033	-4.7^a	-1.0^a	0	2.9^a	-0.750^b
Pre-gestational weight	Average measured	3,714	12.822	48.0	56.0	63.9	80.1	61.98
	Average reported	3,714	12.654	46.6	54.3	61.6	77.9	60.47
	Average pre-gestational weight difference^c	3,714	3.436	-3.0^a	0	1.8^a	6.6^a	1.510^b
Weight at the last appointment	Average measured	6,546	13.396	57.2	65.9	74.6	91.4	72.436
	Average reported	6,546	13.282	57.5	66.6	75.2	91.1	72.654
	Average weight difference at the last appointment^c	6,546	2.092	-2.6^a	-0.6^a	0	2.4^a	-0.218^b
Pre-gestational BMI	Average measured	1,446	4.835	19.4	22.1	25.3	31.2	24.479
	Average reported	1,446	4.717	18.7	21.6	24.2	30.2	23.69
	Average pre-gestational BMI difference^c	1,446	1.723	-1.3^a	0	0.8^a	3.1^a	0.790^b

Variable	Height			p	Pre-gestational weight			p	Weight at the last appointment			p	BMI			p

	Accuracy*		Total		Accuracy*		Total		Accuracy*		Total		Accuracy*		Total

	N	% per category	n		N	% per category	N		N	% per category	N		N	% per category	N
Place of the PN				< 0.05				< 0.05				0.158				0.091
Public service	3,388	63.9	5,303		1,305	47.1	2,772		3,928	75.9	5,176		794	62.1	1,279
Private service	223	70.8	315		467	59.3	788		894	78.6	1,138		66	69.5	95
Both	158	64.0	247		75	50.7	148		172	76.4	225		52	72.2	72
Total	3,769	64.3	5,865		1,847	49.8	3,708		4,994	76.4	6,539		909	62.8	1,446
Geographic region				< 0.05				< 0.05				< 0.05				0.129
North	505	63.8	792		113	42.5	266		359	67.6	531		114	68.7	166
Northeast	1,209	63.5	1,903		456	44.7	1,019		1,531	76.6	2,000		279	59.4	470
Southeast	1,250	62.4	2,002		878	54.4	1,615		2,067	77.8	2,658		298	63.5	469
South	568	70.0	811		336	49.6	677		861	77.8	1,107		164	62.8	261
Midwest	248	66.0	376		65	47.8	136		182	72.5	251		56	70.9	79
Total	3,780	64.2	5,884		1,848	49.8	3,713		4,987	76.4	6,547		908	63.0	1,445
Age group (years)				0.283				0.272				< 0.05				0.347
12–19	865	66.0	1,310		281	46.8	600		1,039	72.5	1,434		172	62.1	277
20–34	2,638	63.8	4,132		1,383	50.3	2,751		3,496	77.4	4,515		657	62.6	1,049
> 34	273	62.8	435		185	51.1	362		459	77.5	592		83	69.2	120
Total	3,776	64.3	5,877		1,849	49.8	3,713		4,994	76.3	6,541		912	63.1	1,446
Race				< 0.05				< 0.05				0.276				< 0.05
White	1,131	66.8	1,692		746	54.1	1,380		1,721	77.9	2,208		331	70.9	467
Black	301	61.2	492		110	42.5	259		424	76.4	555		46	44.2	104
Brown	2,277	63.2	3,602		975	48.0	2,032		2,789	75.5	3,693		526	61.2	859
Yellow	53	76.8	69		16	48.5	33		47	72.3	65		8	57.1	14
Indigenous	17	65.4	26		2	20.0	10		17	77.3	22		1	33.3	3
Total	3,779	64.3	5,881		1,849	49.8	3,714		4,998	76.4	6,543		912	63.0	1,447
Marital status of the mother				0.946				0.056				0.067				0.255
Without partner	724	64.4	1,125		292	53.6	545		914	74.4	1,229		121	66.9	181
With partner	3,055	64.2	4,755		1,557	49.1	3,168		4,083	76.8	5,314		791	62.5	1,266
Total	3,779	64.3	5,880		1,849	49.8	3,713		4,997	76.4	6,543		912	63.0	1,447
Education of the mother				< 0.05				< 0.05				< 0.05				< 0.05
Incomplete BE	1,008	62.8	1,604		319	40.1	795		1,390	74.3	1,872		183	52.6	348
Complete BE	1,175	63.2	1,858		440	46.2	953		1,368	75.3	1,817		278	63.9	435
Complete HS	1,421	65.2	2,178		891	54.0	1,649		1,893	77.9	2,431		394	66.7	591
Complete HE and more	164	74.2	221		191	63.7	300		324	81.8	396		54	81.8	68
Total	3,768	64.3	5,861		1,841	49.8	3,697		4,975	76.4	6,516		909	63.0	1,442
Economic class				< 0.05				< 0.05				0.189				0.073
Classes A+B	581	69.2	839		507	55.8	909		984	78.3	1,257		162	69.5	233
Class C	2,106	63.4	3,321		968	48.4	1,999		2,683	75.9	3,534		534	62.0	861
Classes D+E	1,069	63.9	1,673		366	46.6	786		1,291	75.7	1,705		209	60.9	343
Total	3,756	64.4	5,833		1,841	49.8	3,694		4,958	76.3	6,496	0.178	905	63.0	1,437
Number of prenatal appointments				0.629				< 0.05				< 0.05				0.348
1–3	320	63.0	508		67	47.9	140		347	60.9	570		23	57.5	40
4–5	668	63.4	1,054		136	40.6	335		964	70.5	1,367		81	58.3	139
6 or more	2,790	64.6	4,319		1,647	50.8	3,240		3,688	80.0	4,608		807	63.7	1,267
Total	3,778	64.2	5,881		1,850	49.8	3,715		4,999	76.4	6,546		908	63.0	1,446
Number of previous pregnancies				< 0.05				< 0.05				< 0.05				< 0.05
Zero	1,632	65.4	2,495		939	55.2	1,701		2,130	77.0	2,765		458	67.9	675
1	1,059	64.6	1,638		525	50.0	1,049		1,376	77.9	1,767		237	60.8	390
2	553	63.6	869		244	44.8	545		817	77.4	1,056		126	57.3	220
3 or more	536	61.0	878		142	33.8	419		676	70.6	957		91	55.8	163
Total	3,780	64.3	5,880		1,850	49.8	3,714		4,999	76.4	6,545		912	63.0	1,448

Variable	Height					Pre-gestational weight					Weight at the last appointment					Pre-gestational BMI

	N	Sensitivity (%)				N	Sensitivity (%)				n	Sensitivity (%)				n	Sensitivity (%)

		1^st Q	2^nd Q	3^rd Q	4^th Q		1^st Q	2^nd Q	3^rd Q	4^th Q		1^st Q	2^nd Q	3^rd Q	4^th Q		Low weight	Adequate	Overweight	Obesity
Place of the PN	5,863					3,710					6,538					1,447
Public service	5,302	85.9	56.6	61.6	82.0	2,774	85.5	67.7	66.5	87.1	5,175	93.8	76.2	94.2	92.9	1,280	44.8	81.1	74.1	90.6
Private service	314	90.2	58.1	71.2	94.2	787	86.1	76.8	83.4	87.2	1,138	91.4	73.1	94.2	97.2	95	50.0	79.0	75.0	53.3
Both	247	80.0	47.8	59.3	88.1	149	92.3	65.5	75.7	87.7	225	94.6	76.0	97.4	91.7	72	33.3	86.0	64.3	58.3
Geographic region	5,883					3,715					6,545					1,450
North	793	83.6	73.7	62.2	48.2	266	91.4	67.9	69.3	83.3	529	91.7	89.4	70.2	97.0	167	72.7	94.4	46.8	68.4
Northeast	1,901	82.7	68.7	63.6	52.3	1,019	84.4	66.3	67.6	88.6	2,000	93.3	86.5	84.5	95.3	470	63.2	86.4	60.2	58.0
Southeast	2,003	75.6	68.3	69.5	63.9	1,616	80.0	57.0	79.7	91.1	2,658	91.6	92.6	80.5	97.3	470	92.0	86.9	55.1	84.2
South	811	86.9	77.4	70.2	66.8	677	86.6	71.4	79.0	93.3	1,107	88.4	89.4	83.2	97.9	263	87.5	88.4	55.3	68.8
Midwest	375	77.9	66.2	68.9	50.5	137	80.0	69.7	77.8	82.1	251	78.7	90.7	85.1	96.8	80	80.0	84.8	64.7	28.6
Age group (years)	5,877					3,711					6,540					1,447
12–19	1,310	85.1	68.0	68.4	57.2	599	86.5	67.5	78.5	82.7	1,434	90.5	86.6	77.8	95.9	278	84.6	78.3	39.3	42.9
20–34	4,133	80.2	72.1	66.2	59.1	2,750	82.7	62.0	75.3	91.1	4,514	91.8	90.2	82.5	96.9	1,050	75.0	90.5	57.0	70.8
> 34	434	81.8	63.1	69.0	59.3	362	78.3	66.7	75.9	90.3	592	93.1	95.1	81.0	98.5	119	100	90.0	73.9	86.4
Race	5,887					3,790					6,489					1,448
White	1,693	82.4	72.6	67.6	63.6	1,377	87.1	61.3	79.7	90.7	2,207	89.7	90.3	82.2	97.9	466	94.1	92.2	69.4	75.0
Black	494	62.9	67.9	72.4	58.9	260	79.1	67.6	69.6	94.0	555	91.7	89.6	81.9	98.2	105	100	87.5	31.1	87.5
Brown	3,601	82.7	68.9	65.5	56.8	2,030	81.8	64.3	74.0	90.0	3,693	92.0	89.2	81.2	96.1	861	72.0	85.1	55.1	67.6
Yellow	70	100	85.0	72.7	60.0	32	87.5	80.0	75.0	85.7	11	94.7	94.1	77.8	90.9	14	100	100	25.0	50.0
Indigenous	29	80.0	100	57.1	50.0	10	100	0	100	100	23	100	100	100	100	2	0	0	0	0
Marital status of the woman	5,882					3,715					2,519					1,447
Without partner	1,126	82.6	62.3	65.8	57.7	546	73.7	47.0	65.9	94.7	1,228	92.0	91.7	80.4	98.7	181	81.8	88.9	53.7	85.7
With partner	4,756	81.0	72.2	67.2	59.7	3,169	85.4	67.0	77.1	90.1	1,291	91.2	89.1	81.9	96.7	1,266	78.7	87.6	56.7	69.8
Education level	5,860					3,697					5,061					1,444
Incomplete BE	1,604	79.3	70.2	66.0	56.8	794	84.3	63.5	67.5	82.3	1,872	92.6	85.4	80.5	94.8	349	63.2	84.1	47.6	69.0
Complete BE	1,858	83.7	66.4	67.0	53.4	954	83.8	64.6	76.9	88.8	359	91.3	88.5	80.8	98.6	436	88.9	84.7	52.7	64.6
Complete HS	2,178	81.0	72.9	66.6	63.9	1,650	81.7	60.3	77.8	94.2	2,432	90.2	93.8	82.2	97.4	591	80.0	91.3	60.8	79.2
Complete HE or more	220	93.3	79.4	71.9	65.7	299	90.9	75.0	80.0	92.0	398	92.5	91.7	87.2	96.4	68	100	97.2	72.7	55.6
Economic class	5,830					3,692					6,497					1,438
Classes A+B	837	80.5	70.3	69.3	66.3	910	86.2	73.8	82.3	93.7	1,260	89.9	90.5	82.4	98.0	234	90.9	86.7	65.0	64.3
Class C	3,322	80.9	70.6	67.5	60.1	1,997	82.5	62.0	73.9	90.8	3,532	90.0	91.0	81.8	96.5	862	82.9	88.6	56.2	73.9
Classes D+E	1,671	81.9	69.9	63.6	50.9	785	83.5	57.6	67.8	84.1	1,705	93.3	86.9	80.7	96.7	342	69.2	85.9	50.6	67.6
Number of PN appointments	5,879					3,714					6,545					1,445
1–3	508	79.5	71.7	59.5	55.7	140	82.1	19.7	73.3	90.5	569	91.3	85.8	64.8	91.2	41	100	88.9	26.7	71.4
4–5	1,053	84.1	71.8	67.1	50.9	334	84.0	67.5	70.3	68.3	1,368	88.2	85.5	82.2	94.9	137	50.0	86.1	47.6	50.0
6 or more	4,318	80.9	69.8	67.7	61.5	3,240	83.5	66.3	76.4	92.2	4,608	92.9	91.6	82.9	97.8	1,267	83.6	87.9	58.8	72.6
Number of previous pregnancies	5,877					3,713					6,544					1,446
Zero	2,495	78.8	70.4	59.1	61.4	1,702	81.7	63.5	79.8	94.2	2,765	91.6	89.6	81.1	97.2	673	88.6	89.8	47.1	67.9
1	1,638	81.2	70.5	66.8	60.8	1,049	87.4	63.1	76.2	89.1	1,766	89.9	91.2	83.0	97.5	390	57.9	83.6	64.4	71.1
2	868	84.0	73.2	59.4	50.0	544	77.6	67.5	70.7	89.9	1,057	92.8	92.6	82.9	95.5	218	71.4	90.3	63.2	80.0
3 or more	876	85.0	67.2	69.7	58.8	418	88.1	58.8	65.5	85.8	956	92.0	83.9	79.0	97.7	165	100	85.3	59.0	65.7
Total	5,884	81.4	70.3	66.9	59.5	3,715	83.5	63.4	75.7	90.5	6,543	91.4	89.6	81.7	97.1	1,448	79.2	87.7	56.2	71.6

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[1] Correspondence: Silvana Granado Nogueira da Gama. Departamento de Epidemiologia e Métodos Quantitativos em Saúde – ENSP/FIOCRUZ Rua Leopoldo Bulhões, 1480. Sala 808 Manguinhos. 21041-210 Rio de Janeiro, RJ, Brasil. E-mail: roberta.araujo.nut@gmail.com